Predictors of quality of life gains among people with type 1 diabetes participating in the Dose Adjustment for Normal Eating (DAFNE) structured education programme

Aims: To examine predictors of quality of life gains among people with type 1 diabetes following the Dose Adjustment for Normal Eating (DAFNE) self-management training programme. Methods: Clinical and questionnaire data were collected from 437 patients from 6 hospital centres before, and 18 months post-DAFNE intervention. Glycated haemoglobin (HbA_1c), weight, height, and blood pressure levels were recorded by clinicians during clinic appointments. Questionnaires included the Diabetes-Specific Quality of Life Scale (DSQOLS), the Problem Areas in Diabetes Scale (PAID) and the Hospital Anxiety and Depression Scale (HADS). Basic demographics were recorded at baseline. Linear mixed models were fitted to identify predictors of change in quality of life at an 18 month follow-up assessment. Results: Patients with high levels of diabetes-related distress experienced greatest improvement in DSQOLS quality of life scores (p=0.001). Patients with poor glycaemic control (higher levels of HbA_1c; p=0.03) and those with high levels of anxiety (p=0.001) experienced the greatest reductions in diabetes-related distress. Conclusions: Patients with higher baseline levels of anxiety, higher levels of diabetes-related distress and higher baseline levels of HbA_1c are most likely to experience quality of life gain from participation in self-management programmes such as DAFNE.